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Randomized Control Intervention Evaluating the Effects of Acute Exercise on Depression and Mood Profile: Solomon Experimental Design

      To the Editor:
      Our nonexperimental epidemiological research demonstrates that bouted (≥10 minutes) and nonbouted (<10 minutes) physical activity (PA) is favorably associated with a number of health outcomes (eg, cardiometabolic parameters,
      • Loprinzi P.D.
      • Cardinal B.J.
      Association between biologic outcomes and objectively measured physical activity accumulated in ≥10-minute bouts and <10-minute bouts.
      health-related quality of life,
      • Loprinzi P.D.
      • Davis R.E.
      Bouted and non-bouted moderate-to-vigorous physical activity with health-related quality of life.
      and reduced mortality risk
      • Loprinzi P.D.
      Accumulated short bouts of physical activity are associated with reduced pemature all-cause mortality: implications for physician promotion of physical activity and revision of current US government physical activity guidelines.
      ). These are important findings because non-bouted PA, in particular, may be easier for adults (particularly those with chronic disease) to adhere to in an exercise program.
      • Loprinzi P.D.
      • Cardinal B.J.
      Association between biologic outcomes and objectively measured physical activity accumulated in ≥10-minute bouts and <10-minute bouts.
      What has yet to be conducted, however, is an experimental study of the effect of an acute 5-minute bout of exercise (walking) on depression symptoms and mood profile. Thus, the purpose of this study was to evaluate the effects of a 5-minute bout of walking (chosen to maximize practicality) on depression symptoms and mood profile while using a 4-group Solomon experimental design. This design allows for the evaluation of a treatment (exercise) effect, replication of the treatment effect, ascertainment of a testing effect, and evaluation of whether the pretest interacts with the treatment.
      On the basis of the sample size in our previous experimental work,
      • Loprinzi P.D.
      • Kane C.J.
      Exercise and cognitive function: a randomized controlled trial examining acute exercise and free-living physical activity and sedentary effects.
      88 young adults were randomized into 1 of the 4 experimental arms (N=22 subjects per study arm; mean age, 21.6±0.4 years); see Table. Notably, there were no differences (Ps>.05) in age, sex, race-ethnicity, education, or sleep behavior across the experimental arms (data not shown). Identical to our other work,
      • Loprinzi P.D.
      • Kane C.J.
      Exercise and cognitive function: a randomized controlled trial examining acute exercise and free-living physical activity and sedentary effects.
      mood profile was assessed via the Profile of Mood States (POMS) questionnaire. The POMS was administered before and after the acute 5-minute bout of walking, which occurred in our laboratory, on a treadmill, using a self-selected walking pace (meanmph for both walking groups was 3.5; P=.46). As discussed elsewhere,
      • Loprinzi P.D.
      • Kane C.J.
      Exercise and cognitive function: a randomized controlled trial examining acute exercise and free-living physical activity and sedentary effects.
      • Edwards M.K.
      • Loprinzi P.D.
      Effects of a sedentary behavior-inducing randomized controlled intervention on depression and mood profile in active young adults.
      overall mood (lower score is more favorable) was assessed from ascertainment of the following psychological parameters: depression/dejection, hostility/anger, and fatigue/inertia. The Table presents the findings for overall mood across the 4 experimental arms, but notably, when evaluating the individual psychological parameters, findings for depression/dejection and fatigue/inertia were similar to the displayed overall mood results. As shown in the Table, a 5-minute bout of walking improved overall mood profile (including lowering depression symptoms), we were able to replicate this treatment effect, and there was no evidence of a testing effect or an interaction between the pretest and treatment.
      TableOverall Mood Scores Across the 4-Group Solomon Experimental Design (N=88)
      O = observation (mood assessment); R = random assignment; T = treatment (5-min bout of walking on a treadmill at a self-selected intensity).
      ,
      Mood, overall mood score from the Profile of Mood States (POMS) questionnaire; lower score is more favorable. Variance estimates in parentheses are standard error values. Groups 1 and 2 consist of the traditional parallel group randomized controlled design. Amount of change due to T (is O2-O1 different than O4-O3?). Replication of T effect (is O5 different than O6?). Testing effect (is O4 different than O6?). Pretest interacts with T (is O2 different than O5?).
      Treatment effect

      Is O1 different than O2?

      39.7 vs 35.7, P=.003
      Group 1 (n=22)RO1

      Mood=39.7 (2.4)
      TO2

      Mood=35.7 (1.6)
      Control group

      Is O3 different than O4?

      41.1 vs 40.1, P=.25
      Group 2 (n=22)RO3

      Mood=41.1 (1.9)
      O4

      Mood=40.1 (1.9)
      Change due to treatment

      Is O2-O1 different than O4-O3?

      −4.0 vs −1.0, P=.05
      Group 3 (n=22)RTO5

      Mood=33.2 (0.6)
      Replication of treatment effect

      Is O5 different than O6?

      33.2 vs 45.5, P<.001

      Testing effect

      Is O4 different than O6?

      40.1 vs 45.5, P=.14

      Pretest interacts with treatment

      Is O2 different than O5?

      35.7 vs 33.2, P=.15
      Group 4 (n=22)RO6

      Mood=45.5 (2.9)
      a O = observation (mood assessment); R = random assignment; T = treatment (5-min bout of walking on a treadmill at a self-selected intensity).
      b Mood, overall mood score from the Profile of Mood States (POMS) questionnaire; lower score is more favorable. Variance estimates in parentheses are standard error values. Groups 1 and 2 consist of the traditional parallel group randomized controlled design. Amount of change due to T (is O2-O1 different than O4-O3?). Replication of T effect (is O5 different than O6?). Testing effect (is O4 different than O6?). Pretest interacts with T (is O2 different than O5?).
      As discussed elsewhere,
      • Loprinzi P.D.
      • Cardinal B.J.
      Association between biologic outcomes and objectively measured physical activity accumulated in ≥10-minute bouts and <10-minute bouts.
      few (∼5%) adults meet PA guidelines. This may be partly due to the guideline's inclusion of a 10-minute minimum time-bout requirement for PA. Our findings suggest that a shorter, 5-minute bout of PA is adequate to elicit psychological health benefits. This may be encouraging to individuals who perceive “lack of time” as an exercise barrier. Individuals may also perceive this shorter time requirement to be less physically demanding. Notably, the present study demonstrates that mood-related benefits of a 5-minute exercise bout can occur from a self-selected walking pace. A self-selected pace is generalizable, and encouragingly, this may positively influence an individual's confidence in his or her ability to sustain activity and his or her anticipated enjoyment of the activity. Health care providers should consider the positive benefits of a 5-minute bout of exercise when prescribing treatment for patients suffering from mood-related disorders.

      References

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        • Cardinal B.J.
        Association between biologic outcomes and objectively measured physical activity accumulated in ≥10-minute bouts and <10-minute bouts.
        Am J Health Promot. 2013; 27: 143-151
        • Loprinzi P.D.
        • Davis R.E.
        Bouted and non-bouted moderate-to-vigorous physical activity with health-related quality of life.
        Prev Med Rep. 2015; 3: 46-48
        • Loprinzi P.D.
        Accumulated short bouts of physical activity are associated with reduced pemature all-cause mortality: implications for physician promotion of physical activity and revision of current US government physical activity guidelines.
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        • Loprinzi P.D.
        • Kane C.J.
        Exercise and cognitive function: a randomized controlled trial examining acute exercise and free-living physical activity and sedentary effects.
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        • Edwards M.K.
        • Loprinzi P.D.
        Effects of a sedentary behavior-inducing randomized controlled intervention on depression and mood profile in active young adults.
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